My concern is becoming a charge RN in a city hospital with 1 1/2 years ER experience only. Previous experience was mostly Mother/Baby nursing about 14 years and Med/Surg 2 years. This has been mostly hands-on learning at this facility with a high turn over on the night shift. I work week-ends only at this time and every shift is full speed ahead usually the entire 12 hour shift!!!Most of our experience nurses have moved to days or to another facility with better staffing, pay or benefit packages.
My decision making has improved, but I feel your charge nurse needs to have more ICU/CCU background. I would like to know the legal ramifications of being charge. Are you responsible leagally for all those that work on your shift?? We have many new nurses coming to this shift and the orientation process is not adequate due to short staffing and busy ER.
I would appreciate any input that you can offer.
Feb 24, '02
you stated, it should be someone who has some icu/ccu experience? let me say, i have never worked in a unit (as regualr staff....just when they need the extra help).
they threw me in charge 11 months out of school, into the er. i did it for a year, and then quit doing it.
not because it was difficult, or tough. i quit because there were too many dinosaurs around, and they would not listen to me. they did their own thing no matter what, and so i quit doing it.
about a year after i quit doing charge, they asked me if i would do it again. by this time most of the dinosaurs quit and went elsewhere, or changed shifts and it woudn't affect me. so i said yes. two years later i took a manager position.
i was told a few months ago, when i was there i was to be in charge no matter what. this came up, because i would often come in, and delegate it to somebody else....and just take an assignment.
why? because taking an assignment without the charge hassles, is way less stressful. guess now it's part of the job description.
anyways....... you are not legally responsible for everyone in the er. although if your like me, you feel that way most of the time. i try to know, all 17-24 patients in the front part of the er, inside and out (i.e. complaint, labs, ekg's, tests, etc), but that's just me. i want to know who is nothing, and who can go bad in a heartbeat.
the way things are now days, having 17 rooms, doesn't mean 17 patients. it means that 17 rooms will be filled, and the rest will be in the halls. if i'm not on top of all of them, then i can't conclude which most likely need a room, with/without a monitor, with/without o2 etc. etc.
i don't claim to be god, allah, budda or some supernurse. the thing is, the docs have an overwhelming amount of confidence in me. we have a lot of new grads that come in to the er. we also have had a lot of new to er people come into work there. unfortunately, there is not only a lack of nurses out there, but alack of seasoned er staff.
my suggestion......it's difficult enough, to not feel responsible for everybody wheh your in charge. help the people (within reason) that need help, and let those that can handle it on their own do their thing. when you see or feel a patient is headed down the tubes, stick with that patient. help that nurse out. they all don't go bad at once. most of all, don't sign every freakin chart in the place.
you can't possibly take care of every patient in the er yourself. sign too many charts at one time, and the lawyers will lick their chops.
just my 2 cents
p.s. - you'll be fine!!! :d any questions, give me a buzz. this is not meant to sound arrogant, rude or make you worry. it's just how i look at the picture. every artist paints a different picture.
Last edit by CEN35 on Feb 24, '02